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Annual Report and Accounts 2019/20 Annual report and accounts 2019/20 Lincolnshire Community Health Services NHS Trust | Annual Report and Accounts 2019/20 Page 2 of 68 Lincolnshire Community Health Services NHS Trust | Annual Report and Accounts 2019/20 Contents Page 5 Introduction Welcome from the Chair 5 Trust purpose 5 Our activities 6 Our work 7 About the Trust 7 Our strategic aims and objectives 8 The LCHS way 8 Page 9 Performance report Overview 9 A statement from the chief executive 9 Financial performance 13 Service developments in 2019/20 13 Summary of LCHS structure and the services provided 15 Challenges for Lincolnshire health and care service 19 The Lincolnshire health and care system 19 Brexit 20 Key issues and risks to achieving LCHS’ objective 21 Single Oversight Framework (SOF) 24 Quality account performance 24 Quality priorities and achievement 25 Quality summary of performance 25 Performance summary 27 Page 3 of 68 Lincolnshire Community Health Services NHS Trust | Annual Report and Accounts 2019/20 Contents continued Page 28 Accountability report Corporate governance report 28 Directors’ report 28 Composition of the Board of Directors 28 Register of directors’ interests 30 Statement of the chief executive’s responsibilities as the 33 accountable officer of the trust Annual Governance Statement 34 Review of effectiveness 46 Page 47 Remuneration and staff report Board members and senior management remuneration 47 Relationship between the remuneration report and exit 52 packages, severance payments and off-payroll engagements disclosures Staff report 54 Schedule of information 57 Employee matters 58 Page 68 Financial statements 68 Page 4 of 68 IntroductionLincolnshire Community Health Services NHS Trust | Annual Report and Accounts 2019/20 Trust Purpose Elaine Baylis | Trust Board Chair Lincolnshire Community Health Service NHS Trust provides a wide Welcome to the Annual Report and Accounts for range of community care across Lincolnshire meeting the physical Lincolnshire Community Health Services NHS health needs of our community as close to their homes as possible. Trust (LCHS). The Lincolnshire Health System is undergoing significant change meeting the direction of the NHS Long Term Plan and local This year our growth has been in building partnerships and new population health needs. This provides the opportunity to make relationships to deliver improved services for the population of positive changes to healthcare in Lincolnshire which ensures care Lincolnshire. As this introduction is being written the world is in the is close to home and acute care is focussed on those people in midst of a global Covid-19 pandemic that has changed the lives of most need. everyone and seen the NHS given new prominence in the country. This means a real focus on renewed and refreshed pathways of care developed with partners in the local healthcare system. It From the weekly round of applause for key workers; to the fantastic means working in on population health needs locally in partnership vision of Captain Tom Moore’s 100th Birthday Walk for the NHS in with GP practices and their overarching primary care networks an effort to raise £1,000. Indeed, such is the esteem the NHS is (PCNs). It means supporting patients to manage their own care seen in that Captain Tom Moore’s fundraising has raised £32m needs and supporting them to look after themselves, which means million at the time of writing. that they will get better quicker with great outcomes. The Covid-19 pandemic has galvanised the health and care providers in Lincolnshire and LCHS has played its part in working with these partners to discharge patients from the acute hospitals and also in transferring staff to help in critical care settings within those hospitals. Page 5 of 68 Lincolnshire Community Health Services NHS Trust | Annual Report and Accounts 2019/20 Our activities Working in this way means we will continue to deliver the safe, The Trust has a wide portfolio of healthcare services that includes: effective and efficient evidence based care that resulted in our • children’s and young people’s services including looked after ‘Outstanding CQC’ rating. We will need to continue to shape our children and children’s therapy services services so they are flexible to any emerging priorities and able to • electronic assistive technology service (EATS) take on new opportunities as healthcare is positioned in the best • general and specialist integrated community nursing place for patients, in the community. • immunisation and vaccination services • inpatient beds and outpatient clinics in four community hospitals Our Trust is well placed to help deliver the changes and together • minor injuries unit with partners we are already seeing improvements that benefit • musculoskeletal (MSK) physiotherapy services patients and make better use of the funding available. • occupational therapy, physiotherapy and speech and language therapy • podiatry service There is no secret to give great healthcare to our communities • primary care services in Boston and Spalding within the funding we are given. It relies on our great workforce, • safeguarding services for both children and adults. service users being heavily involved in their own care and working • sexual health and contraceptive health services in partnership to deliver improvements that we all recognise as • urgent care services including Urgent Treatment Centres at good. Louth, Skegness, Lincoln, Boston and Peterborough Page 6 of 68 Lincolnshire Community Health Services NHS Trust | Annual Report and Accounts 2019/20 Our work The Trust has the expertise in a wide range of community services – delivered through our 1,780 (1,572 WTE) committed staff – they support and improve the wellbeing of people in Lincolnshire and parts of Peterborough. This expertise in healthcare is broad and supports all aspects of community care representing a range of professions including nurses, allied health professionals, public health professionals and GPs. These NHS-trained staff are being shared, rotated and deployed across the NHS system to where they are required. This crucial resource not only provides high quality clinical care and expertise, but also coordinates, connects and advocates for About the Trust patients & carers. This includes core areas such as: The Trust delivers care across the whole of Lincolnshire and parts of Peterborough. The Trust covers four Commissioning Groups • Leading integration opportunities (CCGs) and Lincolnshire County Council. • Supporting people with long term conditions • Frailty and end of life care Our services are delivered from over 64 different sites; some of our • Urgent care main sites are: Head Office – Beech House, Witham Park, Lincoln • Specialist in prevention, case management, risk County Hospital, Louth John Coupland Hospital, Gainsborough management and appropriate discharge Johnson Community Hospital, Spalding Bourne Health Clinic Riversdale Health Clinic, Sleaford Lindon House, Lincoln Details of our services are accessible on our website. Page 7 of 68 Lincolnshire Community Health Services NHS Trust | Annual Report and Accounts 2019/20 Our strategic aims and objectives The LCHS Way The LCHS Way is “we listen, we care, we act, we improve” We listen: we engage with everyone we work with | we are united | we are always positive We care: everyone is valued, respected and developed | knowledge and skills are nurtured | success is celebrated We act: Clear goals and the right resources | freedom coupled with accountability | emphasis on simplicity We Improve: we are creative, resourceful and innovative | integration & collaboration is the way forward | we’re always striving to do better Page 8 of 68 Lincolnshire Community Health Services NHS Trust | Annual Report and Accounts 2019/20 Performance Overview A statement from the chief executive providing her perspective on the performance of LCHS during 2019/20 Maz Fosh | Chief Executive Lincolnshire Community Health Services NHS Trust We are Lincolnshire Community Health Services NHS Trust (LCHS), the primary community healthcare provider in Lincolnshire delivering community-based services. In partnership with other health and social care services we care for thousands of patients across Lincolnshire every day delivering joined-up care in a range of community settings appropriate to the needs of the patient including: patients’ homes or a place of residence they call home, including nursing and care homes; GP surgeries; community clinics; hospices; homes providing community transitional care beds; community hospitals; and within acute hospital settings. This puts us at the heart of the Lincolnshire healthcare economy. Our mission is to provide outstanding community care. By providing services aimed at preventing health problems from getting worse, Page 9 of 68 Lincolnshire Community Health Services NHS Trust | Annual Report and Accounts 2019/20 we help to support a shift from care in acute hospitals into more and the public called ‘Healthy Conversation’. This has helped LCHS joined-up care close to the patient’s home. to understand our patients, staff and stakeholders, their LCHS has an annual turnover of c. £108m and employs c. 1,900 experiences and how they would like to see services continue and members of staff. After being rated an ‘Outstanding’ organisation improve. Through a series of workshops, community engagement overall by the Care Quality Commission (CQC) following our last events, and social media channels the things we heard include that inspection in June 2018,
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